HSJ Performance Healthcheck

This interactive online tool will provide comparative data on specific indicators for every NHS organisation with exclusive performance benchmarking analysis for HSJ readers.

Every month we will launch a new data set to enable you to view your own performance and benchmark it nationally and against your peers. Alongside the data is clear, concise comment on the variations in performance and how this fits in the wider NHS context.

Harnessing national data sources Performance Healthcheck is designed to help you understand how you can do more with less and make actionable decisions.

How to use Performance Healthcheck

Select one of the topics listed below. You will then be presented with a map selection screen where you can choose to look at data for a particular region or nationally.

Find out more

There have been numerous reports, papers and articles published discussing the commissioning of or reduction in commissioning of treatments of 'low clinical value' or 'low priority' as well as the definitions of such lists; for example, Save to invest - Commissioning for equity (London Health Observatory, 2007); Reducing spending on low clinical value treatments (Audit Commission, 2011). A common theme of these reports is the variation in the application of these lists across the country. This month's Performance Healthcheck provides an example analysis of 10 elective treatments that sometimes feature on these lists and the variations that appear across PCTs and nationally over time.

The enhanced version of Dr Foster Intelligence's Real Time Monitoring (RTM) tool now features additional Patient Safety Indicators (PSIs) and service line indicators from the 2010 Hospital Guide. These indicators enable the monitoring and identifying of potential instances of patient harm. The new PSIs were developed by the Agency for Healthcare Research and Quality (AHRQ) in the United States and translated by the Dr Foster Unit at Imperial College London and in conversation with other leading indicator developments units. The methodologies for these indicators were also made available pre-Hospital Guide publication for comment and consultation, in partnership with HSJ last summer. The results of two of the indicators, Decubitus Ulcer and Accidental Puncture or Laceration are showcased in this month's Performance Healthcheck.

Length of stay between trusts has always shown great variation. There has been a larger focus in recent years at reducing length of stay to improve the patient experience by reducing the number of days spent in hospital, freeing up beds in hospital for new patients and therefore saving the trust money. This example analysis shows how the variation has reduced over time and how far more trusts are now appearing in the lowest band for length of stay for this particular procedure than five years ago.

Recent analysis by Alcohol Concern (Making alcohol a health priority - Opportunities to reduce alcohol harm and rising costs, 2011) reported that the 'number of hospital admissions due to alcohol misuse was 1.1 million in 2009/10, a 100% increase since 2002/03. If the rise continues unchecked, by the end of the current Parliament a staggering 1.5 million people will be admitted to hospital every year' This indicator provides a summary view of the number of admissions attributable to alcohol for each PCT by sex.

This indicator reviews outpatient attendance, cancellation and DNA (did not attend) rates with a view to discussing the impact of the winter season. The monthly trend analysis shows the seasonal variation in attendance rates and the winter of 2009 shows an increase in DNAs and cancellations.

This indicator provides an indication of the potential savings to be gained by reducing the number of first outpatient attendances that do not have any follow-up appointments or admissions within a given timeframe. The concept behind this is to not only review the appropriateness of some GP referrals but also to assess whether savings can be made to the health economy by caring for patients in primary care rather than in hospital.

The introduction of a marginal tariff is likely to affect the level of emergency admissions. It is hoped that capping 2010-2011 income at the level of admissions for 2008-09 and only paying 30% of tariff for activity thereafter will reduce admissions. While they are reducing their liability in respect of the trusts, PCTs should be actively managing demand locally.

The introduction of a marginal tariff is likely to affect the level of emergency admissions. It is hoped that capping 2010-2011 income at the level of admissions for 2008-09 and only paying 30% of tariff for activity thereafter will reduce admissions. This policy will clearly directly affect trusts' income and thus they need to engage upstream with PCTs to reduce local demand.

Patient Safety Indicators

Developed by the Agency for Healthcare Research Quality (AHRQ) in the United States and translated by the Dr Foster Unit at Imperial College London, PSIs enable you to monitor and identify potential instances of patient harm around the following indicators: Show indicators

PSI Decubitus Ulcer

PSI Deaths after surgery

PSI Infections associated with central line

PSI Post-operative hip fracture

PSI Post-operative haemorrhage or haematoma

PSI Post-operative physiologic and metabolic derangements

PSI Post-operative respiratory failure

PSI Post-operative pulmonary embolism or DVT

PSI Post-operative sepsis

PSI Post-operative wound dehiscence

PSI Accidental puncture or laceration

PSI Obstetric tear - vaginal delivery with instrument

PSI Obstetric tear - vaginal delivery without instrument

PSI Obstetric tear - caesarean delivery

Service Line Indicators

How does your performance compare for key services?

Benchmarking performance across care pathways helps you monitor and identify potential problems with the quality of outcomes and care teams.

RTM now includes key performance indicators for stroke and orthopaedics to give a total view of quality in these services: Show indicators